de Sena Barbosa Mateus Gonçalves, Otávio da Silva Vinícius, Santos Ferreira Luiz Henrique, de Souza Rafaela Luiza Vilela, Pipek Leonardo Zumerkorn, de Oliveira Almeida Gustavo, Figueiredo Eberval Gadelha, Rabelo Nicollas Nunes, Chaurasia Bipin
Department of Neurosurgery, Atenas University Center, Passos, MG, Brazil.
Department of Neurosurgery, Atenas University Center, Paracatu, MG, Brazil.
Ann Med Surg (Lond). 2024 Oct 25;86(12):7232-7237. doi: 10.1097/MS9.0000000000002692. eCollection 2024 Dec.
The simultaneous occurrence of intracranial aneurysms (IA) and primary brain tumors (BT) is frequently reported, with an estimated incidence of 0.5-7.4%. Among the tumor types associated with IA, pituitary adenomas (PA) are the most prevalent.
The authors selected articles, published from 1960 to December 2023, on the Medline, Embase, Scopus, Cochrane Library, and Web of Science databases. The extraction form contains information specific to the aneurysm and tumor, rupture of the aneurysm, treatment proposal for both and order of treatment and outcome.
The study evaluated 118 patients from 25 articles. The most frequent types of tumors were non-functioning hormone (NFA) producers, present in 45.8% (=54) of the cases, and growth hormone (GH) secretors, which represent 23.0% (=27) of the cases. The main treatment used was surgery, with subtotal resection (STR) performed in 4.2% (=5) of cases, gross total resection (GTR) in 3.4% (=4), and transsphenoidal resection (TSR) in 7.6% (=9). 16.0% (=19) of patients had two or more aneurysms concomitant with the adenoma. IA treatment was performed before PA surgery in 25 patients (21.2%) and 15 patients received simultaneous treatment to IA and PA (12.7%).
Patients with PAs have a considerable prevalence of IAs. Hormonal imbalances and mechanical changes induced by tumor growth, particularly influenced by GH and IGF-1, contribute to this coexistence. Surgical intervention is common, requiring meticulous precautions to avoid complications. More longitudinal studies including close follow-up with a description of outcomes are necessary to guide treatment protocols for this condition.
颅内动脉瘤（IA）与原发性脑肿瘤（BT）同时发生的情况屡有报道，估计发病率为0.5 - 7.4%。在与IA相关的肿瘤类型中，垂体腺瘤（PA）最为常见。
作者检索了1960年至2023年12月期间发表在Medline、Embase、Scopus、Cochrane图书馆和科学网数据库上的文章。提取表包含动脉瘤和肿瘤的特定信息、动脉瘤破裂情况、两者的治疗建议以及治疗顺序和结果。
该研究评估了25篇文章中的118例患者。最常见的肿瘤类型是无功能激素（NFA）分泌型，占病例的45.8%（=54例），生长激素（GH）分泌型占病例的23.0%（=27例）。主要治疗方法是手术，4.2%（=5例）的病例进行了次全切除（STR），3.4%（=4例）进行了全切除（GTR），7.6%（=9例）进行了经蝶窦切除（TSR）。16.0%（=19例）的患者有两个或更多动脉瘤与腺瘤并存。25例患者（21.2%）在PA手术前进行了IA治疗，15例患者（12.7%）接受了IA和PA的同步治疗。
PA患者中IA的患病率相当高。肿瘤生长引起的激素失衡和机械变化，特别是受GH和IGF - 1影响，促成了这种共存。手术干预很常见，需要精心预防以避免并发症。需要更多的纵向研究，包括密切随访并描述结果，以指导这种情况的治疗方案。
